I deal with alcohol and depression in the second chapter of Alcohol Explained (the first 5 Chapters can be read by clicking here: Alcohol Explained 1st 5 Chapters) although it is contained with the wider topic of alcohol’s physiological effect on human beings. I have read a few things recently about alcohol and depression, all of them acknowledged the link between alcohol and depression and addressed the question of whether it is the case that alcohol causes depression or whether people prone to depression are more likely to develop a drinking problem.
What is often missed is that there is no reason why these two hypotheses should be mutually exclusive, so the starting point is not whether one or the other is correct, but rather whether one or the other or both are correct.
In fact it is the case that both are correct. Alcohol causes depression no matter how mentally or physically healthy or ‘normal’ you are to begin with, but it is also the case that people who are prone to depression (or even mental health issues more generally) also tend to gravitate to drinking, and more importantly heavy and problem drinking. Let’s look at both of these in turn.
As I state in Chapter 2, alcohol is an anaesthetic and a depressant (and I am using the word ‘depressant’ here in its technical sense, ie a drug that reduces functional or nervous activity). But it is also the case that the human body is not a passive object, it is reactive, and by this I mean that it reacts to the world around it and whatever food and drugs are put into it. The brain has its own store of drugs that it releases at the appropriate times (such as adrenaline, serotonin, dopamine, etc). So if you introduce a depressant, the brain will take steps to counter it. It does this in two ways, firstly by introducing a stimulant to counter it. The brain’s supply of each particular drug is limited, but the more it is used the more the brain produces of it and the more proficient it becomes at releasing it at the appropriate time. It is also the case that those parts of the brain that are particularly receptive to the effects of alcohol become more sensitive so that they can still work when under the influence of alcohol. Simple.
So introduce alcohol and the brain counters it. The more often we do this and the more alcohol we consume the better the brain becomes at countering it. However when the alcohol wears off the brain does not return to normal until sometime after the alcohol has left our system, so after each drinking session there is a period afterwards during which we have an overstimulated, over sensitive mind and we do not return to normal for some time. This period is the physical alcohol withdrawal period and it is during this period that we are prone to depression. To put is simply the brain is in disarray as a direct result of the alcohol we have consumed. The more alcohol we consume during any particular session and the more proficient our brain is at countering the alcohol, the more disarray our brain will be in and the more prone we will be to depression during this period.
Let’s turn now to those with mental health issues and in particular depression. Being an anaesthetic and a depressant alcohol takes the edge off our feelings. If we are feeling tired, upset, or miserable alcohol will take the edge off this. So if we are upset for any reason (be this because of the everyday stresses or strains that every human being encounters to some degree or another, a major event, or because of inherent mental health issues) we are more likely to turn to alcohol as a form of relief. And of course after the drinking session we not only have the original depression, but also the additional depression caused by alcohol withdrawal, which makes our need for relief all the greater.
Everyone who drinks goes through the alcohol withdrawal period, however most people just get on with it. The brain may be in some form of disarray, but most of us have busy lives. We get up, go to work and get on with our lives and the withdrawal just sits in the background. We may be more uptight and worried but life runs at its own pace. Most people tend to just get through it. This is particularly the case if we have no particular worries and are generally fairly happy. In this case a bout of alcohol withdrawal won’t really affect us much, we may be more mentally weak during it but overall the situation is manageable. Even with the misery caused by the withdrawal we may not, overall, be that unhappy. However if we are already unhappy or depressed the additional alcohol withdrawal can start to tip us over the edge. We desperately need relief from this, and an alcoholic drink will not only counter the overstimulated over sensitive mind, but it will as ever provide some relief to the non-alcohol related depression. So taking a drink in this situation will move us from an unbearable depression to feeling fairly ok. This is where we start to enter the world of serious alcoholism. The choice appears to be either an alcohol free life of chronic depression, or a life of constant drinking which at least provides some degree of mental tranquillity. In fact it is not really a choice at all, that level of depression is so overpowering that we will grasp at anything that provides any degree of relief, no matter what the side effects.
It is a fairly dark picture until we factor in that the key word here is, of course, ‘apparent’. It only appears to be a choice between these two very unappealing options. Fortunately there is a third and much better option, and that is to entirely remove the alcohol withdrawal element not by drinking, but by not drinking. This not only provides permanent, long term relief from the short term alcohol withdrawal, but also over time provides relief from the physical and mental debilitation caused by heavy drinking, as well as relief from the negative impact long term intoxication has on our personal relationships and financial position.